Psych Review Notes 4 Flashcards
What is the DSM criteria for Major Depressive Episode?
(5/9) FIVE of the following NINE sx (need #1 or #2) for at least a 2 week period:
1-Depressed Mood (feel sad or blue)
2-Anhedonia (don’t like things)
3-Change in appetite/body weight (eating)
4-Change in sleep habits (sleeping)
5-Feelings of worthlessness or guilt (guilt)
6-Unable to concentrate on things (concentration)
7-Psychomotor agitation (restlessness or slowness)
8-Fatigue or Loss of energy (no energy)
9-Recurrent thoughts of death or suicide (SI)
Like bipolar, MDD may have psychotic features.
But it is not as common.
What medical conditions could cause depressive episode?
Endocrine (thyroid, cortisol, calcium)
Neuro diseases (parkinson’s, mononucleosis)
Cancer (lymphoma, pancreatic)
SLE (lupus)
What is the DSM criteria for Major Depressive Disorder?
-at least one major depressive episode
2-no signs of manic or hypomanic episode
-depression is the second leading disability in world (behind CHF)
What sleep problems are associated with MDD?
Multiple awakenings
Initial and terminal insomnia Hypersomnia
REM (rapid eye movement) sleep earlier in night
What is seasonal affective disorder (SAD?)
Subtype of MDD where the episodes only occur during the winter months. Pts are classically IRRITABLE, HYPERSOMNIC and have CARBOHYDRATE cravings.
What is dysthymic disorder?
Depressed mood for most days for at least two years
Two of the following:
Poor appetite or overeating (eating)
Poor sleep (sleep)
Feelings of hopelessness/guilt
Feelings of low self esteem
Difficulty concentrating or making decisions
Fatigue or loss of energy
-doesn’t list anhedonia or SI, adds low self-esteem
During the period pts have not been w/o above symptoms for >2 mo at a time and do not meet criteria for Major Depressive Episode.
-if patients are psychotic, this is not the diagnosis.
-note 50% of cases are under 25 and 2x MC in women
What is double depression?
Patients with MDD who have dysthymic disorder in residual periods (Dysthymic disorder in betw episodes)
What is cyclothymic disorder?
Alternating periods of hypomania and mild/mod dep
- no actual major depressive or manic episodes
- associated with borderline personality disorder (B)
- males=females and onset usually 15-25 years (young)
- 1/3 of these patients advance to BPADII
- treat with antimanic agents
Is MDD more common in women or in men? Avg age? Risks?
2x more common in women
Can occur in any age, average onset is 40
No ethnic or socioeconomic differences
Very prevalent in elderly (1/4 to ½ by some estimates)
2-3x greater risk if + family hx
What % of depressed patients have SI? What % commit suicide?
About 2/3 have SI
About 10-15% commit suicide
What is the kindling theory of depression?
With each episode of depression (may last mos to yrs) pts are more prone to have further depressive episodes triggered with weaker stimuli or stressors.
What are the five possible outcomes during depression?
Response, Remission, Relapse, Recovery and Recurrence
What are the % risks of recurrent MDD episodes?
50% after 1, 70% after 2 and 90% after 3 episodes
What is cognitive therapy (CBT) for depression?
Focuses on the here & now, very little exploration of person, focuses on correction of abnormal thought connections based on person’s experience.
-used for black & white or catastrophic thinking, etc
What is interpersonal therapy (IPT) for depression?
Focuses on the Here & Now, uses the relationship with therapist as a vehicle, helps to redefine one’s relationships w/others
- narrower use to include grief, role transition, role dispute
- used for bulimia nervosa patients
